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Luis Schiper, Bluma Linkowski Faintuch, Roberto José da Silva Badaró, Erica Aparecida de Oliveira, Victor E Arana Chavez, Elisangela Chinen, Joel Faintuch
OBJECTIVES: Conventional imaging methods are excellent for the morphological characterization of the consequences of osteonecrosis; however, only specialized techniques have been considered useful for obtaining functional information. To explore the affinity of radiotracers for severely devascularized bone, a new mouse model of isolated femur implanted in a subcutaneous abdominal pocket was devised. To maintain animal mobility and longevity, the femur was harvested from syngeneic donors...
October 1, 2016: Clinics
Yong Lu, Zhiyong Wang, Wei Han, Hao Li
Zoledronate has been reported to exhibit pro‑apoptotic and anti-angiogenic effects in endothelial cells, which partially contributes to bisphosphonate‑associated osteonecrosis of the jaw (BP‑ONJ). Zoledronate can also induce autophagic cell death. The present study hypothesized that Zoledronate may activate autophagy to exert pro‑apoptotic effects in endothelial cells and aimed to investigate the effect of Zoledronate on human umbilical vein endothelial cells (HUVECs) and explore the underlying mechanisms...
October 12, 2016: Molecular Medicine Reports
Christian Walter, Bilal Al-Nawas, Tim Wolff, Eik Schiegnitz, Knut A Grötz
OBJECTIVE: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed...
December 2016: Int J Implant Dent
N M Al-Namnam, P Nambiar, P Shanmuhasuntharam, M Harris
Dengue is a mosquito transmitted flaviviral infection which can give rise to severe haemorrhage (dengue haemorrhagic fever/DHF) and with capillary leakage induces hypovolemic shock (dengue shock syndrome/DSS). Although dengue symptoms and complications have been known for many decades there has only been one documented case of osteonecrosis of the maxilla which was treated by excision of the necrotic bone. In this case of dengue infection, extensive maxillary osteonecrosis and minimal root resorption appeared to follow factitious injury with a toothpick but resolved with nonsurgical management...
October 15, 2016: Australian Dental Journal
Kimona Issa, Todd P Pierce, Steven F Harwin, Anthony J Scillia, Anthony Festa, Michael A Mont
BACKGROUND: HIV is prevalent worldwide and numerous patients with this diagnosis ultimately may become candidates for TKA. Although some studies have suggested that complications are more common in patients with HIV who undergo TKA, these studies largely were done before the contemporary era of HIV management; moreover, it is unclear whether patients with HIV achieve lower patient-reported outcome scores or inferior implant survivorship. QUESTIONS/PURPOSES: We asked whether there were any differences in the outcomes of patients with HIV without hemophilia who undergo TKA compared with a matched control cohort in terms of: (1) patient-reported outcomes; (2) implant survivorship; and (3) complication rates...
October 14, 2016: Clinical Orthopaedics and related Research
Marina Kunstreich, Sebastian Kummer, Hans-Juergen Laws, Arndt Borkhardt, Michaela Kuhlen
The morbidity and toxicity associated with current intensive treatment protocols for acute lymphoblastic leukemia in childhood become even more important as the vast majority of children can be cured and become long-term survivors. Osteonecrosis is one of the most common therapy-related and debilitating side effects of anti-leukemic treatment and can adversely affect long-term quality of life. Incidence and risk factors vary substantially between study groups and therapeutic regimens. We therefore analyzed 22 clinical trials of childhood acute lymphoblastic leukemia in terms of osteonecrosis incidence and risk factors...
October 14, 2016: Haematologica
Thomas Mücke, Christian R Krestan, David A Mitchell, Jan S Kirschke, Arno Wutzl
For patients with malignant disease taking bisphosphonates and denosumab, the incidence of medication-related osteonecrosis of the jaw (MRONJ) is up to 15% in contrast to 0.01% in patients with osteoporosis. Clinical presentation of MRONJ extends from asymptomatic exposure of bone in 94% of patients to severe cases of mandibular fractures in a minority of 4.5%. The strongest risk factors for MRONJ are invasive dental procedures and dental infections. Advances in imaging provide more preoperation information compared with panoramic radiograph...
July 2016: Seminars in Musculoskeletal Radiology
Mahdi Gholami, Reza Shahakbari, Somayeh Abdolahpour, Masoud Hatami, Azam Roshanmir
INTRODUCTION: Herpes zoster Infection (HZI) is a viral disease with painful skin rashes and blisters in a limited area on one side of the body, often in a strip. Osteonecrosis with spontaneous exfoliation of teeth in association with HZI of the mandibular nerve is a rare phenomenon. In this report, such an unusual complication of HZI is presented. CASE REPORT: The clinical course of a 53-year-old woman and a 54-year-old man with HZI associated with alveolar bone necrosis and tooth exfoliation were reviewed in order to develop a patient profile for this rare combination of physical findings...
September 2016: Iranian Journal of Otorhinolaryngology
Hye-Yeon Kim, Jin-Woo Kim, Sun-Jong Kim, Sang-Hwa Lee, Hong-Soo Lee
To assess the relevance of previous epidemiologic studies on bisphosphonate-related osteonecrosis of the jaw (BRONJ), we first conducted a systematic review of large population-based observational studies, and evaluated the validity of claims-based algorithms for the identification of BRONJ. Studies containing primary observational epidemiologic data regarding bisphosphonate exposure and outcomes of osteonecrosis of the jaw were systematically reviewed. Using surrogates for identifying potential BRONJ cases from a population-based hospital registry, validation was performed through medical chart review...
October 13, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
M Pedrazzoli, L Autelitano, F Biglioli
Mandibular fracture is usually the clinical end of bisphosphonate-related osteonecrosis of the jaw. This is a painful complication and patients cannot feed as usual, with a worsening of their quality of life. The goal of treatment in bisphosphonate related osteonecrosis of jaw (BRONJ) patients is to slow progression of bone necrosis. We present a novel technique for treatment of severe mandibular BRONJ in stage 3 patients that present with a high risk to develop fracture, since they have a residual unaffected mandibular bone height less than 6 mm...
August 2016: Acta Otorhinolaryngologica Italica
Diego H Díaz, Julieta A Rodas, Clarisa E Bozzini, Patricia M Mandalunis, Natalia D Escudero
Bisphosphonates are the first choice therapy for the pharmaco logical treatment of osteoporosis. Following reports of cases of bisphosphonaterelated osteonecrosis of the jaw and atypical femur fracture, the safety of longterm use of bisphosphonates has been evaluated, resulting in the proposal of strontium as an alternative drug. No experimental study using a sequential administration design has been reported to date. Hence, the aim of this study was to evaluate the effect on bone tissue of ovariectomized rats of administration of alendronate followed by strontium ranelate...
September 2016: Acta Odontológica Latinoamericana: AOL
Shin Saeng Lim, Beomseok Lee, In Sook Kim, Soon Jung Hwang
OBJECTIVES: Osteonecrosis of the jaw has been increasing after dentoalveolar surgery in patients treated with an antiresorptive bisphosphonate (BP), especially strong zoledronate (ZA). The pathophysiology underlying why osteonecrosis occurs exclusively in the jaw bone remains unclear. This study investigated skeletal site-specific bone healing during the use of BPs to explore the preferential incidence of osteonecrosis of the jaw bone. STUDY DESIGN: Extraction of mandibular molar and creation of a tibia defect were performed in rats 2 weeks after weekly intravenous injections with the potent ZA and the weaker BP etidronate...
August 18, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Thomas Lombard, Virginie Neirinckx, Bernard Rogister, Yves Gilon, Sabine Wislet
In recent years, medication-related osteonecrosis of the jaw (MRONJ) became an arising disease due to the important antiresorptive drug prescriptions to treat oncologic and osteoporotic patients, as well as the use of new antiangiogenic drugs such as VEGF antagonist. So far, MRONJ physiopathogenesis still remains unclear. Aiming to better understand MRONJ physiopathology, the first objective of this review would be to highlight major molecular mechanisms that are known to be involved in bone formation and remodeling...
2016: Stem Cells International
Alexandru Movila, Hani Mawardi, Kazuaki Nishimura, Tomomi Kiyama, Kenji Egashira, Jae-Young Kim, Alessandro Villa, Hajime Sasaki, Sook-Bin Woo, Toshihisa Kawai
Prior consensus held that medication-related osteonecrosis of the jaw (MRONJ) lesion was composed of necrotic bone; however, more recent studies have identified inflammatory infiltrates in the lesion. Herein, we report that remarkably elevated infiltrating γδT cells (90% of lymphocytes) express Semaphorin 4D (Sema4D) in human patient with MRONJ lesion, whereas γδT cells only account for 2-5% of lymphocytes in blood. Importantly, Sema4D is implicated in the pathogenesis of T cell-mediated inflammatory diseases, such as rheumatoid arthritis and multiple sclerosis...
October 5, 2016: Biochemical and Biophysical Research Communications
Zohaib Akram, Tariq Abduljabbar, Sergio Varela Kellesarian, Mohamed Ibrahim Abu Hassan, Fawad Javed, Fahim Vohra
AIMS: The aim of this systematic review was to assess the efficacy of bisphosphonate therapy as an adjunct to scaling and root planing (SRP) in the management of periodontitis. METHODS: Databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched up to and including July 2016. The primary outcome was probing depth (PD), and the secondary outcomes were changes in clinical attachment level (CAL) and bone defect (BD) fill...
October 8, 2016: British Journal of Clinical Pharmacology
Ying Gao, Xu Wang, Chunnian He
ETHNOPHARMACOLOGICAL RELEVANCE: Reactive oxygen species (ROS) mediate vascular cell dysfunction and lead to atherosclerosis and other chronic cardiovascular diseases. The root of Pueraria lobata (Willd.) Ohwi, also known as kudzu or Gegen (Chinese name), is one of the most important herbs in traditional Chinese medicine and has been widely used in the treatment of cardiovascular diseases, diabetes, osteonecrosis and neurodegradation diseases. In this study, an ethanol extract from kudzu root was prepared and the in vitro protective effect of the kudzu root extract (KUD) on human umbilical vein endothelial cells (HUVECs) was investigated...
October 4, 2016: Journal of Ethnopharmacology
Gurpal S Pannu, Craig P Eberson, Joshua M Abzug, Bernard D Horn, Donald S Bae, Martin Herman
Supracondylar humerus fractures and lateral condyle fractures are the two most common pediatric elbow fractures that require surgical intervention. Although most surgeons are familiar with supracondylar humerus fractures and lateral condyle fractures, these injuries present challenges that may lead to common errors in evaluation and management and, thus, compromise outcomes. It is well agreed upon that nondisplaced supracondylar fractures (Gartland type I) are best managed nonsurgically with cast immobilization...
February 15, 2016: Instructional Course Lectures
Joshua M Abzug, Christine Ann Ho, Todd F Ritzman, Brian Brighton
Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed...
February 15, 2016: Instructional Course Lectures
Jenny A F Vermeer, Greetje A P Renders, Marion A van Duin, Ineke D C Jansen, Lieneke F Bakker, Sophie A Kroon, Teun J de Vries, Vincent Everts
OBJECTIVES: Bisphosphonates are widely used to treat bone diseases such as osteoporosis. However, they may cause osteonecrosis of the jaw. Here, we investigated whether in vivo exposure to bisphosphonates has a different effect on long bone and jaw osteoclasts, and on the turnover of these different bones. MATERIALS AND METHODS: Zoledronic acid (0.5 mg/kg weekly) was administered intraperitoneally to 3-month-old female mice for up to 6 months. The effects on the number of osteoclasts, bone mineralization, and bone formation were measured in the long bones and in the jaw...
October 5, 2016: Oral Diseases
Yang Song, Zhenwu Du, Qiwei Yang, Ming Ren, Yujie Sui, Qingyu Wang, Ao Wang, Haiyue Zhao, Jincheng Wang, Guizhen Zhang
The critical roles of IGFBP3 in regulating the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cells strongly indicate its potential effects on the pathogenesis of osteonecrosis of the femoral head (ONFH). In this study, we investigated the association of IGFBP3 gene polymorphism and its protein expression with the development of ONFH to further explore its molecular pathogenesis. Ligase detection reactions and enzyme-linked immunosorbent assay were used to detect the polymorphisms of rs2453839[C/T] and rs3110697[A/G] and the serum protein expression of IGFBP3 gene in 182 cases and 179 controls, respectively...
October 5, 2016: DNA and Cell Biology
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